Saturday, December 22, 2007

A much needed break

The last eight weeks of work were absolutely draining. I spent 4 weeks in the PICU and then 4 months as senior resident on one of the general pediatrics inpatient teams. While I was inpatient, I took overnight in-house call every 4th night, and I am so tired. If I don't see another child with RSV for a while, it will still be too soon! I had so many random hilarious things happen last month and so many random frustrating things to balance out the funny that I am just exhausted.

I managed to work out my days off from last month, my vacation time, and my Christmas break time to work together to give me 13 days in a row off. I will probably NEVER have this much time off again, so I'm definitely enjoying it while it lasts. I'm now on day 8 and have loved every day of sleeping in (which means not getting up til 7:30). We hosted our Sunday School class Christmas party at our house last Saturday and had a blast! We spent last Sunday afternoon with Hubby's dad and 2 sisters and had a mini-Christmas since parts of that side of the family won't be together again this year. This afternoon, my parents and 2 siblings are coming in to stay with us for the next 4 days, and I cannot wait.

Christmas is my absolute favorite time of year. I love everything about it -- the food, the smells, the gift-giving, the decorations. This year has been even better since Hubby and I are the ones hosting Christmas. We have scrubbed the house from top to bottom and hung all our decorations. We have our formal Christmas tree downstairs and our homey Christmas tree upstairs. The house smells like a combination of the sugar cookies and cranberry-orange scones I baked last night, and my first turkey is sitting in the fridge getting ready to be brined soon (thanks, Food Network and Alton Brown!). I even have the cutest Santa outfit for Sebastian! Best of all, I have been able to attend church last Sunday with Hubby and will go tomorrow with my side of the family as well as Hubby; sharing fellowship with my brothers and sisters in Christ is even more beautiful to me this time of year after my long absence due to work. I am so thankful for the miracle of my King's coming, and while I know this time of year is likely not the actual time of His birth, I enjoy using it as a time to celebrate His story. Thanks be to God for His indescribable gift!

Monday, November 12, 2007

Nice surprise

Earlier today I began an entry on my experience this weekend as I watched the aftermath of a horrible tragedy that resulted in a young child dying in his mother's arms. I was not there for the end due to duty hour rules, but I was there for the beginning. It was so horrible that I pray no one else ever has to go through this. I recognize that we unfortunately live in an imperfect world, and this terrible scenario will likely play out again in that same unit time after time.

That said, I'm not ready to deal with the emotions that this experience is evoking. Instead, I've decided to blog about the happier side of the last three days.

Saturday I left the hospital and came home to Hubby. It was the first time I'd seen him since Sunday night (technically I saw him Monday morning, but I was half asleep, so it doesn't count), and boy was it good to be in the same house with him.

Sunday I had to go to work, and I had a SICK patient. She was a complete mystery to multiple teams, so I ended up staying in the PICU hours later than I had planned. I didn't have an official breakfast that day, and my lunch consisted of a cold piece of pizza I ate as I left the hospital at 2:45 that afternoon. The upside of Sunday? My dad was in town, so we picked him up and had a delicious dinner at Cantina Laredo.

Today I slept ten hours straight -- glorious. I had a meeting with my program director at 3, so I left the house after lunch to run some errands before the meeting. I'm asking for new jeans for Christmas, so I dropped into my favorite store for jeans to try on a pair. To my extreme pleasure, I have dropped a jean size!! I noticed that my jeans had been quite loose lately, so today's dressing room revelation came as an expected but pleasant surprise. After I got home, I made a HUMONGOUS batch of fudge and 2 loaves of pumpkin spice bread. Now I'm preparing to watch my favorite TV show, Heroes. Life is good! :)

Monday, November 05, 2007

Strength to carry on

This weekend I experienced one of the hardest moments of my life. I've been in the Pediatric Intensive Care Unit (PICU) for the last two weeks, and I have seen children make it through things I never want to think about again. On Saturday, one of our team's patients didn't make it. We had tried to keep him alive for a few weeks, but eventually even out last ditch efforts were obviously beginning to fail. Almost all of us, including me, knew that we needed to let him go, but we had been giving his family time to come to that realization as well. By Saturday, his mom was there, but his dad was still asking for more time.

I had to be in the room as our attending explained to this child's parents that we were rapidly running out of interventions to keep him alive. My attending comforted them by reminding them that their child was not awake and that he was not feeling pain. The chaplain and a family friend made it to the room, and I helped the nurses clean his broken little body as best we could. We disconnected his lines, we turned off his monitors, and finally they pulled out his breathing tube and the other tubes going down his nose and face.

None of us really knew this patient. He had never opened his eyes, never spoken, never woken up for the entire time we cared for him, yet through hearing his family speak about him and seeing pictures of him, we felt like we knew him. We all watched as this patient that we had fought so hard to save took a few shallow breaths and then stopped breathing. His parents began to cry, and I fought so hard not to cry myself. We stepped out of the room to give them time alone with their son before returning a few minutes later to make the final pronouncements.

It was interesting to see how the different members of the team responded to this. Some stood around joking about inane little things to take their minds off what happened, some immersed themselves in busy work, and some left our part of the unit entirely. Until Saturday, I had never been in the room when a child died, and it was every bit as hard as I anticipated, so I didn't know what to do to make this any easier for myself. As we had been in the room with the family, I found myself silently crying out to God for them, but after we left the room for the last time, I was too busy taking care of the patients I still had left to stop and focus on everything that had just happened.

This patient was not one of my normal patients. I had never been the main provider for him before; it had always been someone else, but due to shift requirements and work schedules, I was covering him for only four hours that day. Right before he was handed off to me, I knew how sick he was, and I found myself hoping that he wouldn't die on my shift. Initially I felt guilty for hoping that he would survive five hours instead of three, but when I realized the source of my fears, I didn't feel so bad. This was previously uncharted territory; I had never directly been in the room when a child died, and I didn't have a strong connection with the family. I didn't know what my role would be, and I was scared of doing the wrong thing. I am not personally afraid of death because I know what will happen to me when I die, but I was and still am afraid of death when it comes to others. As it became obvious that we wouldn't be able to keep him alive, I just began to pray that God would help me do the right things and be a tool in His hands.

After it was all over, I made the appropriate phone calls and filled out the necessary forms. His dad asked me if he could keep the blanket we had covered his child with so that only his face and shoulders, the least visibly damaged parts, would be seen. We heartily reinforced that this blanket and anything else they needed was theirs, and they thanked us before quietly slipping out, never to come back.

The chaplain found me later and thanked me "for everything," but it felt so ridiculous that she would thank me at all as I felt I hadn't done anything for them. She told me that on the way out of the hospital, our patient's mom had expressed that she didn't know why God had allowed this to happen but that He was in control and that she would continue to trust Him. Such amazing faith in the face of such tragedy! How I pray that my faith would be as strong!

I was at work for about an hour and a half more after the death before signing out to the night shift person. While I was there, I was able to smile and keep a cheerful appearance, but as soon as I stepped out of the hospital, I began to feel a huge weight being lowered down onto my shoulders. I called Hubby to let him know I was on my way home, and for once, I didn't feel like talking during the drive. I started to cry as drove down I-35 and began to call out to God for this family. I don't know if half of my words would have been intelligible to the human ear, but I know that God heard and understood me. After I got home, I just needed to be held by Hubby as I cried. Later he listened to me as I talked through the events of the day, and I was begin to process what had just happened.

I still don't have answers to make all of the pieces fit together. Why this happened will never make sense to me, but I have faith that God is good and that He works in ways I will never understand. I will continue to pray for this family and for myself that I may be a tool in His hands.

Thursday, October 25, 2007

Again?!?

I am sick yet again. I didn't feel so hot in clinic yesterday, and by the time I got home, it was definitely not good. I threw up around 8 PM and went to bed without dinner. This morning I ate a few crackers for breakfast as rounds were starting, but I didn't have the appetite for anything else. Around 10 AM, my attending told me to call in sick call because he could tell I didn't feel well. I almost started crying right there in the middle of rounds because I was doing everything I could not to call in sick call, but I felt so horrible that I just wanted to go home.

I made myself some soup when I got home, so in the last 30 hours, I have eaten about 6 saltines and a cup of chicken noodle soup. I'm considering some Jello for dinner, but we'll see. At least I have tomorrow off, so I don't have to worry about calling in sick call for a second day.

I'm in the PICU this month. I'm definitely not an intensivist! There are plenty of valuable lessons for me to learn in my 28 days here, but I am so out of my element. I'm seeing such horrible things that I usually want to go home and cry to get it all out. These kids are so sick, and I'm seeing horrific child abuse that turns my stomach. This month is turning me into even more of an advocate for my patients than I was before! I am so tired; I'm waking up at 4:30-5 am every day, and at least two days a week, I work til 8 PM. I'm only on 30-hour call twice this month, but the first time is Saturday. I'm a little nervous about it, but I know that it will be okay.

I think it's time for Jello and a second episode of Law and Order. I don't have any plans for tonight other than to relax and watch TV with Sebastian. Tomorrow Hubby will be home; I'm hoping that I will at least be eating real food by dinner tomorrow.

Thursday, October 18, 2007

One more thing ...

One more thing I am thankful for is the ability to swallow. My precious patient has lost that ability. I found out today through a text page from another doc taking care of her, and now she is going to require tube feeds. I almost started crying in Fry's shortly after I found out. Later after we got home, I soaked in a hot bath with water up to my chin as I cried out to God and told Him again that I don't know what to do for her. No one seems to know. She is getting worse right in front of our eyes, and there is nothing we can do to stop it.

This is the point where my flesh wants to start disengaging. Looking into her mom's eyes hurts so badly because I cannot provide answers or an honest hope of recovery at this point. Caressing her sweet little face reminds me how fragile she is. Although I continue to pray for a miracle, I am preparing myself for what happens if God chooses not to provide one. She may live a long life, but at this point there are no answers.

Fortunately the Holy Spirit refuses to let me disengage. I am frequently reminded that the best thing I can do for her is to pray. The first time God began to whisper to my heart what He had in store for my life, I was a 14 year old teen volunteer at Hermann Hospital. I was wheeling a patient from the front of the hospital to his room when he began to vomit in front of me. I was a helpless teenager who had no clue what to do, but I was overcome with a desire to help this man. The words from a song called "Not Too Far From Here" (originally sung by Kim Boyce) popped into my head: "Help me, Lord, not to turn away from pain; help me not to rest while those around me weep. Give me Your strength and compassion when somebody finds the road of life too steep."

Little did I know that six years later, He would call me to medical school, and four years later, He would call me to take care of His little ones. I see His fingerprints every day in the beauty that is the human body. I see His miracles everywhere I turn. How one could practice medicine and not believe in God is beyond me.

I can cry for my patient. I can pray for her. I can feel helpless. I can come up with new ideas. I just need to keep remembering that God has a perfect plan, and I need to be ready to be a tool in His hands in any way He wants to use me.


Somebody's down to their last dime
Somebody's running out of time
Not too far from here
Somebody's got nowhere else to go
Somebody needs a little hope
Not too far from here

And I may not know their name
But I'm praying just the same
That You'll use me Lord to wipe away a tear
'Cause somebody's crying
Not too far from here

Somebody's troubled and confused
Somebody's got nothing left to lose
Not too far from here
Somebody's forgotten how to trust
Somebody's dying for love
Not too far from here

It may be a stranger's face
But I'm praying for Your grace
To move in me and take away the fear
'Cause somebody's hurting
Not too far from here

Help me, Lord, not to turn away from pain
Help me not to rest while those around me weep
Give me Your strength and compassion
When somebody finds the road of life too steep

Now, I'm letting down my guard
And I'm opening my heart
Help me speak your love to every needful ear
Jesus is waiting
Not too far from here
Jesus is waiting
Not too far from here

I am thankful ...

... that I'm incapable ... of doin' any good on my own.

Seriously, the tragedy I have been watching around me makes me stop and reflect how many things for which I have to be thankful. Let me give an abbreviated list:

  • My beloved husband
  • My family
  • The best dog in the world
  • My home
  • Indoor plumbing :)
  • Delicious food that is readily and easily accessible (and often somewhat nutritious)
  • Clean, drinkable water
  • My overall good health
  • A supportive work environment
  • Freedom of speech and of worship
  • Easy access to medicine
  • Laughter
  • My new Barista and the delicious coffee that Hubby makes for me before I go to work
  • Christmas CDs that arrive early (yay Amazon.com!)
  • A baby's laugh
  • Seeing miracles everyday with my own eyes
  • Most of all ... my Savior

Tuesday, October 09, 2007

Reflection

Tonight I decided to skip an optional journal club meeting, so Sebastian and I are chilling and doing nothing worthwhile. He's sleeping in my lap while I'm working on wiping out my classic iPod and starting from scratch. Unfortunately my largest CD case is in hubby's car at the airport, but my smaller case with many of my favorite CDs was in mine, so I have decent starting material. I've been enjoying songs I've loved for the last ten+ years, so I felt inspired to fill one of these out.

1. What were you doing 10 years ago? It was October 1997, and I was applying to colleges and going on trips across Texas to figure out where I wanted to be. I was also stressing over my ex-boyfriend (although, as I joke with Hubby, we never officially broke up, so technically ...) and wondering whether or not we should get back together. For the record, we didn't. I had just gotten my driver's license four months earlier and my own car one month earlier, and my braces had FINALLY come off on the same day I got my car. I thought I was the stuff!

2. What were you doing 5 years ago? October 2002 -- I was into my first semester of medical school and FREAKING OUT over anatomy. Yuck. I was also driving almost every weekend to be with a boy who turned out to be bad news. Between studying and driving to see the boy, I didn't have much time for anything else, and I was missing College Station very badly.

3. What were you doing 1 year ago? October 2006 -- I was finishing up my easiest month of intern year (clinic selective) and starting one of my harder months (night float). I was so exhausted and extremely stressed over residency and missing my hubby. I missed Houston so much it hurt! Funny how a place in which I felt so uncomfortable 4 years earlier seemed so much like home.

4. What did you do yesterday? I went to Surgery Clinic and learned about all sorts of surgical problems kids have. Some would gross out anybody non-medical, so I won't give any links. :) Then I went to one of the best stores in the world, Target, and came home to hang out with Sebastian.

5. Snacks I enjoy -- I get on kicks where I will eat certain things over and over and over until I get sick of them, and then I won't touch them for months. The latest passions? Red grapes, pineapple, grill cheese sandwiches, and a glass of milk with a cookie (although I don't eat all those at the same time)

6. Things I would do with $100 million dollars -- Automatic $10 million to my church as a tithe, then extra for missions both abroad and in my hometown. Pay off my student loans, our house, and my car. Take my family and Hubby's family on a trip. Find a family in need and buy Christmas toys for all their children. Save the rest and continue to live our life in a manner much like we live now. It would be nice to not have to pay off my loans and the house, but other than that, I don't think I would want to change much of how we live. God has blessed us with far more than we need.

7. Locations I would run to -- I'd love to go back to Maui with Hubby and take him to Italy and France for his first trip to Europe. We're talking about going to NYC for my first trip there during our vacation in the spring, so I would have to stay I'd go there as well!

8. Bad habits I have -- I bite my nails and do it more when I am nervous. It is so gross, but I do it unconsciously, and that makes it so difficult to stop. I also tend to tune things out when they don't interest me.

9. Things I like to do -- Hang out with Hubby and Sebastian, read, cook, drink a glass of nice wine over a delicious dinner

10. Biggest joy of the moment -- Getting to see my parents this weekend for the first time in ages! I saw them for 1 day at my grandmother's funeral in August, but other than that, I don't think we've spent time together since March. They're going to see our house for the first time since it's been completed and meet Sebastian for the first time. PLUS when they leave on Sunday, Hubby won't be leaving out of town the next day!!! He'll be in town for at least one week -- the first time in eight weeks he won't be getting on a plane on Monday! I am thrilled beyond words. Thursday can't get here soon enough!

Monday, October 08, 2007

A time of renewal

I've been having a pretty rough go at it for the last few months. My patients have been very sick, and I've been separated from my husband much more frequently than I would like. I haven't been "sick" per say, but I have been so much more tired than usual. I have been emotionally drained and haven't felt very "happy" in a while. This has not been an easy time for me.

This weekend was my church's ladies' retreat. I was initially very hesitant about going, but one of the girls from my Sunday School class invited me to stay in her room, so I decided it might be a good idea. I really had no idea what to expect, but I now can see that God was preparing this weekend for me.

Our pastor's mom spoke to us and discussed Romans 12:1-2. The theme of the retreat was "A Time of Renewal," and the Lord used the twenty-two hours I spent in Waxahachie to refresh my soul and meet me in my deepest places of need. He allowed me to deepen relationships with my sisters in Christ and to establish a few new friendships with ladies outside of the typical age range I usually hang out with. He gave me the ability to see my life in a new light and to remember the importance of joy even when trials arise. I was able to return to Dallas with a lighter burden than the one I had brought to the retreat.

The best moment of the retreat came after lunch on Saturday. The main conference room was opened up 30 minutes early to allow us quiet time to pray, read, or meditate on Him. I slipped into the room and curled up in my chair with my head resting on my Bible. As I wept and cried out to Him for myself, my family, my lost friends, my patients, and so many other things, He brought verses to my mind and whispered comfort to my soul. What a sweet and merciful Savior!

Thursday, October 04, 2007

Sometimes

Sometimes things cannot be explained. Sometimes there are no answers.

Tuesday, September 25, 2007

Ready to quit

About fourteen hours after my last post, I stood in another patient's room in the ER as an intern and I explained that their only child likely had cancer and needed to be admitted to the hospital for further tests. Yuck yuck yuck. I was so ready to quit by the end of the week. Four new diagnoses in less than a week ... YUCK. I love pediatrics, but I hate cancer.

I'm back on days. I think today is the first day that my body has remotely been adjusted to normal people hours. Sebastian is so happy to have someone at home with him during normal hours, and since I have not had anywhere to be for the last two afternoons, he and I have been spending some serious quality time together. He's been playing with his new puppy toys while I've been doing research for a presentation I'm giving in two weeks, and now we're both chilling out while Paula Deen teaches us how to make a sinfully delicious caramel apple cheesecake. Yum.

Hubby is still gone during the week. He's on his sixth week in a row out of town and has at least two more to go. Having him gone is horrible; this house is too big for just one person!

Time to get back to work ... I'm no closer to being done with this presentation than I was yesterday. The more research I do, the further I seem to get from finding an answer to my question. Time to press on!